National-level Data Reports
Critical Access Hospitals
National Target Area Analysis – Critical Access Hospitals (101kbs PDF, updated 04-22-2011)
The link below provides national-level statistics for areas identified as at-risk for improper payments in critical access hospitals. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all hospitals in the nation. For more information on the areas identified as at risk for improper payments, please see the Critical Access Hospital PEPPER User’s guide.
National Top 20 DRGs for Critical Access Hospital (83kbs PDF, updated 04-22-2011)
A listing of the top 20 DRGs by volume of Medicare discharges for all critical access hospitals in the nation. The data are aggregated at the national level. The data include the number of discharges, proportion of discharges for the DRG to total discharges and national average length of stay for each DRG. The data represent the most recent four quarters of discharges.
State Target Area Analysis – Critical Access Hospitals (928kbs XLS, updated 04-28-2011)
The link below provides state-level statistics for areas identified as at-risk for improper payments in critical access hospitals. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all hospitals in each state with three or more CAHs. This file is a Microsoft Excel workbook; click on the worksheet tabs to obtain the report for each state. Target area statistics are reported when there are at least 11 target area discharges. For more information on the areas identified as at risk for improper payments, please see the Critical Access Hospital PEPPER User’s guide..
State Top DRGs for Critical Access Hospital (533kbs XLS, updated 04-28-2011)
A listing of the top DRGs (up to 20) by volume of Medicare discharges for all critical access hospitals in each state with three or more CAHs. The data are aggregated at the state level. The data include the number of discharges, proportion of discharges for the DRG to total discharges and average length of stay for each DRG. The data represent the most recent four quarters of discharges. This file is a Microsoft Excel workbook; click on the worksheet tabs to obtain the report for each state. DRGs are included in the report if there are at least 11 discharges for the DRG in the most recent four quarters.
Target Area Analysis – Short-term Acute Care Hospitals (135kbs PDF, updated 12-1-2011)
The link below provides national-level statistics for areas identified as at-risk for improper payments in short-term acute care hospitals. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all hospitals in the nation. For more information on the areas identified as at risk for improper payments, please see the Short-term PEPPER User’s Guide (414kbs PDF).
Top 20 Medical DRGs for One-day Stays for Short-term Acute Care Hospitals (15kbs PDF, updated 12-1-2011)
A listing of the top 20 DRGs by volume of Medicare discharges for medical DRG one-day stays for all short-term acute care PPS hospitals in the nation. The data are aggregated at the national level. One-day stays occur when a patient is admitted as an inpatient on one day and discharged either the same day or on the following day. When the patient dies, leaves against medical advice or is transferred to another short-term acute care PPS hospital (patient status codes 20, 07 or 02), or when the one-day stay has prior observation (revenue codes 760 or 762) of greater than 24 hours (as reported on the claim), these claims are not included in the data. These data represent the most recent four quarters of Medicare discharges.
Top 20 Surgical DRGs for One-day Stays for Short-term Acute Care Hospitals (27kbs PDF, updated 12-1-2011)
A listing of the top 20 surgical DRGs by volume of Medicare discharges for one-day stays for all short-term acute care PPS hospitals in the nation. The data are aggregated at the national level. One-day stays occur when a patient is admitted as an inpatient on one day and discharged either the same day or on the following day. When the patient dies, leaves against medical advice or is transferred to another short-term acute care PPS hospital (patient status codes 20, 07 or 02), or when the one-day stay has prior observation (revenue codes 760 or 762) of greater than 24 hours (as reported on the claim), these claims are not included in the data. These data represent the most recent four quarters of Medicare discharges.
National Payment Error Data FY 2007 (141kbs Excel)
Improper payment error data, including projected national payment error statistics and improper payments by DRG. The data presented here may not match estimates presented in the "Improper Medicare Fee for Service Payments Report" as the data represent only short-term, acute-care inpatient claims, the reporting time frame may be different, and the method of calculating the error rate may slightly differ.
Target Area Analysis – Long-term Acute Care Hospitals (23kbs PDF, updated 04-22-2011)
The link below provides national-level statistics for areas identified as at-risk for improper payments in long-term acute care hospitals. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all hospitals in the nation. For more information on the areas identified as at risk for improper payments, please see the Long-term PEPPER User’s Guide (324kbs PDF).
Top 20 DRGs for Long-term Acute Care Hospitals (7kbs PDF, updated 04-22-2011)
A listing of the top 20 DRGs by volume of Medicare discharges for all long-term acute care PPS hospitals in the nation. The data are aggregated at the national level. The data include the number of Medicare discharges, average length of stay and number and percentage of discharges that are short-stay outliers for each DRG. The data represent the most recent four quarters of discharges.
Inpatient Psychiatric Facilities
National Target Area Analysis – All IPFs (86kbs PDF, updated 07-08-2011)
The link above provides national-level statistics for areas identified as potentially at risk for improper payments in IPFs. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all IPFs in the nation. For more information on the areas identified as potentially at risk for improper payments, please see the IPF PEPPER User’s Guide.
National Target Area Analysis – Free-standing IPFs (86kbs PDF, updated 07-08-2011)
The link above provides national-level statistics for free-standing IPFs for areas identified as potentially at risk for improper payments in IPFs. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all free-standing IPFs in the nation. For more information on the areas identified as potentially at risk for improper payments, please see the IPF PEPPER User’s Guide.
National Target Area Analysis – IPF Distinct Part Units of Short-term Acute Care Hospitals (86kbs PDF, updated 07-08-2011)
The link below provides national-level statistics for IPF distinct part units of short-term acute care hospitals for areas identified as potentially at risk for improper payments in IPFs. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all IPF distinct part units of short-term acute care hospitals in the nation. For more information on the areas identified as potentially at risk for improper payments, please see the IPF PEPPER User’s Guide.
National Top 20 DRGs for All IPFs (18kbs PDF, updated 07-08-2011)
A listing of the top 20 DRGs by volume of Medicare discharges for all IPFs in the nation. The data are aggregated at the national level and include the number of discharges, proportion of discharges for the DRG to total discharges and national average length of stay for each DRG. The data represent the most recent four quarters of discharges through Q1FY11 (January 1 – December 31, 2010).
National Top 20 DRGs for Free-standing IPFs (18kbs PDF, updated 07-08-2011)
A listing of the top 20 DRGs by volume of Medicare discharges for all free-standing IPFs in the nation. The data are aggregated at the national level and include the number of discharges, proportion of discharges for the DRG to total discharges and national average length of stay for free-standing IPFs for each DRG. The data represent the most recent four quarters of discharges through Q1FY11 (January 1 – December 31, 2010).
National Top 20 DRGs for IPF Distinct Part Units of Short-term Acute Care Hospitals (19kbs PDF, updated 07-08-2011)
A listing of the top 20 DRGs by volume of Medicare discharges for all IPF distinct part units of short-term acute care hospitals in the nation. The data are aggregated at the national level and include the number of discharges, proportion of discharges for the DRG to total discharges and national average length of stay for IPF distinct part units for each DRG. The data represent the most recent four quarters of discharges through Q1FY11 (January 1 – December 31, 2010).
Inpatient Rehabilitation Facilities
National Target Area Analysis – All IRFs (23kbs PDF, updated 10-05-2011)
The link above provides national-level statistics for areas identified as potentially at risk for improper payments in IRFs. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all IRFs in the nation. For more information on the areas identified as potentially at risk for improper payments, please see the IRF PEPPER User’s Guide.
National Target Area Analysis – Free-standing IRFs (23kbs PDF, updated 10-04-2011)
The link above provides national-level statistics for free-standing IRFs for areas identified as potentially at risk for improper payments in IRFs. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all free-standing IRFs in the nation. For more information on the areas identified as potentially at risk for improper payments, please see the IRF PEPPER User’s Guide.
National Target Area Analysis – IRF Distinct Part Units of Short-term Acute Care Hospital (23kbs PDF, updated 10-04-2011)
The link below provides national-level statistics for IRF distinct part units of short-term acute care hospitals for areas identified as potentially at risk for improper payments in IRFs. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all IRF distinct part units of short-term acute care hospitals in the nation. For more information on the areas identified as potentially at risk for improper payments, please see the IRF PEPPER User’s Guide.
National Top 20 Rehabilitation Impairment Categories (RICs) for All IRFs (27kbs PDF, updated 10-04-2011)
Listings of the top 20 RICs by volume of Medicare discharges for 1) all IRFs in the nation, 2) all free-standing IRFs in the nation, and 3) all IRF distinct part units of short term acute care hospitals in the nation. The data are aggregated at the national level and include the number of discharges, proportion of discharges for the RIC to total discharges and national average length of stay for each RIC. The data represent the most recent four quarters of discharges through Q2FY11 (April 1, 2010 – March 31, 2011).
National Top 20 Case Mix Groups (CMGs) for All IRFs (30kbs PDF, updated 10-04-2011)
Listings of the top 20 CMGs by volume of Medicare discharges for 1) all IRFs in the nation, 2) all free-standing IRFs in the nation, and 3) all IRF distinct part units of short-term acute care hospitals in the nation. The data are aggregated at the national level and include the number of discharges, proportion of discharges for the CMG to total discharges and national average length of stay for each CMG. The data represent the most recent four quarters of discharges through Q2FY11 (April 1, 2010 – March 31, 2011).